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Show HN: Eligible API for 700+ Health Insurance Companies

eligibleapi.com

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Re: Show HN: Eligible API for 700+ Health Insurance Companies

#71

Post by tehwebguy »

rlucas wrote: post #32
joering2 wrote: post #16

Earlier quoted context omitted.

> Thanks for your comment. Perhaps I am having a bad day, but is it really necessary to thank someone for their question? Seriously, this makes me feel like I am dumb for asking a question. I understand you trying to be extra polite, but I am sure you won't start a conversation with "thank you" every time your wife, son, daughter, lover or employee ask you a question. So while many will appreciate your "politeness th…

Terrible, shortsighted comment. You're really judging the value of an informational API on absolute price per dip?? I know of a guy who has a database for which he charges $5000 per lookup. Is that not a "reasonable price?" Well, turns out it contains contract details, including expiration and re-bidding dates, for multi $-MM corporate contracts. If you're a sales team angling for a $500k commission, paying $5k to lo…

I am insanely interested in knowing more about this guy and his database.

Is it very specific to a certain type of business contract?

Re: Show HN: Eligible API for 700+ Health Insurance Companies

#73

Post by logjam »

kategleason wrote: post #28
jasonkolb wrote: post #25

I wish the raw data was available (is it, somewhere?). I'd love to do some statistical analysis on this and get some real insight about how different insurance companies treat claims.

absolutely. I'll send you over as much raw X12, with removed patient info of course, as you want! Please email support@eligibleapi.com

Just curious - how is it that you have claim data? In fact, how is it that you (if I'm not misunderstanding) are storing any actual live data whatsoever?

Just to clarify...you have some data with patient identifiers already "removed"...or are you stripping it yourselves before sharing?

If the latter (which I hope is not true), how would a third-party like you obtain identifiable data? Why would a third-party providing an eligibility API end up storing data (particularly claim data) of any kind to offer to share?

Re: Show HN: Eligible API for 700+ Health Insurance Companies

#74

Post by logjam »

I don't get this.

I'm a physician, and every insurance company to which I submit claims already has a web service in place to check eligibility...at no charge. Already.

There aren't many interface differences between insurance companies: you typically enter two identifiers, usually either an id number or last name, and birth date. You get full eligibility info immediately.

There's nothing difficult about it. We almost never call insurance companies to get eligibility info - web querying is already in place, and has been for a while.

What problem, at 5 cents for each API CALL (c'mon, really?) is this solving? Why would I want to pay to pass my patient's protected health information through yet another layer (and store? see my comment below about this company's offer of a data "sample") of potential privacy loss?

Re: Show HN: Eligible API for 700+ Health Insurance Companies

#75

Post by kategleason »

logjam wrote: post #74

I don't get this. I'm a physician, and every insurance company to which I submit claims already has a web service in place to check eligibility...at no charge. Already. There aren't many interface differences between insurance companies: you typically enter two identifiers, usually either an id number or last name, and birth date. You get full eligibility info immediately. There's nothing difficult about it. We almos…

What's your specialty?

Re: Show HN: Eligible API for 700+ Health Insurance Companies

#76

Post by kategleason »

kategleason wrote: post #75
logjam wrote: post #74

I don't get this. I'm a physician, and every insurance company to which I submit claims already has a web service in place to check eligibility...at no charge. Already. There aren't many interface differences between insurance companies: you typically enter two identifiers, usually either an id number or last name, and birth date. You get full eligibility info immediately. There's nothing difficult about it. We almos…

What's your specialty?

Also, how many insurance companies do you currently accept?

Re: Show HN: Eligible API for 700+ Health Insurance Companies

#77

Post by logjam »

kategleason wrote: post #76
kategleason wrote: post #75

Earlier quoted context omitted.

What's your specialty?

Also, how many insurance companies do you currently accept?

Many many. I just discussed this with our office manger - checking eligibility is not a problem for us (nor would it be for most practices in my opinion) using web services already in place....and especially not free vs a dollar per 20 queries.

I'm not actually a fan of insurance companies, but please explain why I would want to pay for the hassle of dealing with Yet Another third-party and at the same time expose my patient's protected health info to Yet Another layer of risk?

Re: Show HN: Eligible API for 700+ Health Insurance Companies

#78

Post by kategleason »

logjam wrote: post #73
kategleason wrote: post #28

Earlier quoted context omitted.

absolutely. I'll send you over as much raw X12, with removed patient info of course, as you want! Please email support@eligibleapi.com

Just curious - how is it that you have claim data? In fact, how is it that you (if I'm not misunderstanding) are storing any actual live data whatsoever? Just to clarify...you have some data with patient identifiers already "removed"...or are you stripping it yourselves before sharing? If the latter (which I hope is not true), how would a third-party like you obtain identifiable data? Why would a third-party providin…

Hey logjam! Let me know what specialty you are and how many insurance companies you currently accept when you have a minute. To answer your question: No, we do not have access now nor plan to have access in the future to claims data. The raw X12 I am referring to is a 271 format only (eligibility) and will be generated by our own sample transformation tool. However; it will be based off data passed (with stripped patient identifiers) through the Eligible API so that it can give shape to the differences between payer (insurance) formats. As of 3:05 8/11 I have not shared any yet, but I hope to push some to production by the end of the day!

Re: Show HN: Eligible API for 700+ Health Insurance Companies

#79

Post by kategleason »

logjam wrote: post #77
kategleason wrote: post #76

Earlier quoted context omitted.

Also, how many insurance companies do you currently accept?

Many many. I just discussed this with our office manger - checking eligibility is not a problem for us (nor would it be for most practices in my opinion) using web services already in place....and especially not free vs a dollar per 20 queries. I'm not actually a fan of insurance companies, but please explain why I would want to pay for the hassle of dealing with Yet Another third-party and at the same time expose my…

I see. We certainly would not expose your patient's data. My reply at bottom should help clear that up for you. You forgot to mention what specialty you are?

Re: Show HN: Eligible API for 700+ Health Insurance Companies

#80

Post by kategleason »

felideon wrote: post #43
kategleason wrote: post #28

Earlier quoted context omitted.

absolutely. I'll send you over as much raw X12, with removed patient info of course, as you want! Please email support@eligibleapi.com

You mean you also have claim data (837)? Or do you just have enrollment data (834)? If the former, I wonder if some statistical analysis could be done in order to detect possible fraud, waste, and abuse. (I'm not a data geek or anything, but have I always wanted to learn.)

Nope, sorry we do not handle 837 or 834 EDI transactions at this time.
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